| NPI | 1023585510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251E1200X Physical Therapist, Ergonomics (Licence: NY 038760-1) |
| Additional Taxonomies | 2251H1300X Physical Therapist, Human Factors (Licence: NY 038760-1) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: NY 038760-1) | |
| Enumeration Date | 2018-11-01 |
| Last Update Date | 2018-11-01 |